Myristoleic Acid Promotes Anagen Signaling by Autophagy through Activating Wnt/β-Catenin and ERK Pathways in Dermal Papilla Cells

Alopecia is a distressing condition caused by the dysregulation of anagen, catagen, and telogen in the hair cycle. Dermal papilla cells (DPCs) regulate the hair cycle and play important roles in hair growth and regeneration. Myristoleic acid (MA) increases Wnt reporter activity in DPCs. However, the action mechanisms of MA on the stimulation of anagen signaling in DPCs is not known. In this study, we evaluated the effects of MA on anagen-activating signaling pathways in DPCs. MA significantly increased DPC proliferation and stimulated the G2/M phase, accompanied by increasing cyclin A, Cdc2, and cyclin B1. To elucidate the mechanism by which MA promotes DPC proliferation, we evaluated the effect of MA on autophagy and intracellular pathways. MA induced autophagosome formation by decreasing the levels of the phospho-mammalian target of rapamycin (phospho-mTOR) and increasing autophagy-related 7 (Atg7) and microtubule-associated protein 1A/1B-light chain 3II (LC3II). MA also increased the phosphorylation levels of Wnt/β-catenin proteins, such as GSK3β ( Ser9 ) and β-catenin (Ser 552 and Ser675 ). Treatment with XAV939, an inhibitor of the Wnt/β-catenin pathway, attenuated the MA-induced increase in β-catenin nuclear translocation. Moreover, XAV939 reduced MA-induced effects on cell cycle progression, autophagy, and DPC proliferation. On the other hand, MA increased the levels of phospho (Thr202 /Tyr204 )-extracellular signal regulated kinases (ERK). MA-induced ERK phosphorylation led to changes in the expression levels of Cdc2, Atg7 and LC3II, as well as DPC proliferation. Our results suggest that MA promotes anagen signaling via autophagy and cell cycle progression by activating the Wnt/β-catenin and ERK pathways in DPCs.

Protective effect of Rhododendron weyrichii flower extract against UVB-induced proinflammatory cytokine production in human keratinocytes

Ultraviolet B (UVB) radiation is harmful to the skin and induces cytokine release from keratinocytes leading toinflammatory skin disorders. Previous studies have shown that chronic exposure to UVB radiation increases tumornecrosis factor (TNF)-α and interleukin (IL)-6 secretion through various signaling pathways, resulting in skininflammation and increased risk of skin cancer. The present study was undertaken to investigate the protective effectsof Rhododendron weyrichii flower (RWF) extracts against UVB damage of immortalized human keratinocytes(HaCaT). To determine the anti-inflammatory effects of RWF, we examined UVB-induced proinflammatory cytokineproduction in HaCaT cells in the presence or absence of RWF extract, using enzyme-linked immunosorbent assay(ELISA). The results indicated that the RWF extract inhibited the production of proinflammatory molecules suchas IL-6 and TNF-α, but not IL-8, in UVB-irradiated HaCaT cells. These results demonstrate that RWF potentiallyprotects against UVB-induced skin inflammation. In addition, using high-performance liquid chromatography (HPLC)fingerprinting, kaempferol (0.335 ppm) and astragalin (2.569 ppm) were identified and quantified as RWF extractconstituents. Moreover, we tested the potential application of RWF extracts as a cosmetic treatment by performinghuman skin primary irritation tests. In these tests, the RWF extracts did not induce adverse reactions. Based on theseresults, we suggest that RWF extracts be considered anti-inflammatory candidates for pharmaceutical and/or cosmeticapplications.

Comparison of ex vivo lung perfusion with cold storage in rat donor lung preservation / 上海交通大学学报（医学版）

Objective·To establish stable rat ex vivo lung perfusion (EVLP) model and compare the effect of preservation between EVLP group and cold storage group.Methods· Eight SD rats were reconditioned with EVLP for 4 h and 8 SD rats were under 3-h cold storage and 1-h EVLP.The biological index,wet-to-dry weight ratio and concentration of Evans blue were analyzed between two groups.Results · Wet-to-dry weight ratio of lung tissue in EVLP group was significantly lower (5.08±0.88 vs 6.09±0.48,P=0.012);Oxygenation index in EVLP group was significantly higher [(337.9±35.5) mmHg vs (300.5±21.6) mmHg,P=0.023];Concentration of Evans blue in EVLP group was significantly lower [(36.5±20.3) μg/mL vs (65.0±29.9) μg/mL,P=0.043].Conclusion · EVLP as an alternative to traditional cold storage technique can effectively alleviate the lung damage.

Neurocognitive Dysfunction According to Hypoperfusion Territory in Patients With Moyamoya Disease

OBJECTIVE: To demonstrate the prevalence of cerebral hypoperfusion without focal cerebral lesions in patients with Moyamoya disease (MMD), and the relationship between areas of hypoperfusion and cognitive impairment. METHODS: Twenty-six MMD patients were included. Patients were categorized according to the presence/absence of hypoperfusion in the frontal, parietal, temporal, and occipital lobes on brain single-photon-emission computed tomography (SPECT) after acetazolamide challenge. Computerized neuropsychological test (CNT) results were compared between groups. RESULTS: Only 3 patients showed normal cerebral perfusion. Baseline characteristics were similar between groups. Patients with frontal lobe hypoperfusion showed lower scores in visual continuous performance test (CPT), auditory CPT, forward digit span test, backward digit span test, verbal learning test, and trail-making test. Patients with parietal lobe hypoperfusion showed lower backward digit span test, visual learning test, and trail-making test scores. Related to temporal and occipital lobes, there were no significant differences in CNT results between the hypoperfusion and normal groups. CONCLUSION: MMD patients without focal cerebral lesion frequently exhibit cerebral hypoperfusion. MMD patients with frontal and parietal hypoperfusion had abnormal CNT profiles, similar to those with frontal and parietal lesions. It is suggested that the hypoperfusion territory on brain SPECT without focal lesion may affect the characteristics of neurocognitive dysfunction in MMD patients.

Anti-inflammatory Constituents from Branches of Corylus hallaisanensis Nakai.

Development of bioactive ingredients from natural sources has long been the research project of our laboratory. In this study, the extract from Corylus hallaisanensis Nakai branches was investigated and their anti-inflammatory constituents were identified. The prepared ethanol extract was successively partitioned into n-hexane, ethyl acetate, n-butanol and aqueous layers. Upon anti-inflammatory screenings, ethyl acetate fraction exhibited good nitric oxide production inhibitory activity in lipopolysaccharide-induced RAW 264.7 cells. Further phytochemical studies for the ethyl acetate fractions led to isolation of four constituents such as β-sitosterol (1), 3,3’,4’-tri-O-methylellagic acid (2), carpinontriol A (3) and carpinontriol B (4). All of the compounds were isolated for the first time from this plant. The isolates 2, 3 and 4 showed considerable inhibition on the production of nitric oxide in the RAW 264.7 cell without causing cell toxicities. And compounds 3 and 4 reduced the production of interleukin-6, an inflammatory cytokine, in dose-dependent manner in RAW 264.7 cells. Based on these results, C. hallaisanensis extracts could be potentially applicable as anti-inflammatory agents in pharmaceutical or cosmetic industries.

Chemical compositions and anti-inflammatory activities of essential oils from Aster spathulifolius and Vitex rotundifolia maxim.

The essential oils were prepared from Aster spathulifolius (ASE) and Vitex rotundifolia (VRE) by hydrodistillation and their chemical compositions were investigated by GC–MS. Analysis of ASE provided 15 components and eight of which were identified sesquiterpene compounds. The major components in ASE included germacrene D (35.1 %), trans-caryophyllene (15.9 %) and trans-phytol (14.9 %). On the other hand, VRE provided manoyl oxide (14.3%), α-terpineol (13.1 %) and α-pinene (10.0 %) as major ingredients. To assess the anti-inflammatory effects of the essential oils, the production of nitric oxide (NO) and tumor necrosis factor (TNF)-α were monitored using lipopolysaccharide (LPS)-activated RAW 264.7 macrophages. In this test, ASE and VRE were appeared to suppress both NO and TNF-α synthesis in dose-dependent manner. The results indicate that VRE and ASE could be useful in cosmetic applications as natural products possessing antiinflammatory efficacy

Melanogenesis Inhibitory Activity in the Extracts of Oreocnide fruticosa (Gaudich.) Hand-Mazz. Branches.

Development of anti-melanogenic agents from natural sources has long been the research project of our laboratory. In this study, ethyl acetate extracts of Oreocnide fruticosa (Gaudich.) Hand.-Mazz. branches (OBE) were examined for their melanin synthesis inhibitory activities using B16 melanoma cells. Our results indicated that OBE down-regulates melanin production in a dose-dependent pattern. To clarify the target of OBE action in melanogenesis, we performed Western blotting for the key melanogenic enzymes; tyrosinase, tyrosinase related protein-1 (TRP-1) and TRP-2. The results showed that OBE efficiently inhibited tyrosinase, TRP-1 and TRP-2 in a dose-dependent manner. Therefore, OBE is a good candidate for the further study including identification of the effective chemical constituents as well as their working mechanism for the application of whitening agent in the human skin.

Jeju seaweeds suppress lipopolysaccharide-stimulated proinflammatory response in RAW 264.7 murine macrophages

<p><b>OBJECTIVE</b>To investigate the anti-inflammatory effects of Jeju seaweeds on macrophage RAW 264.7 cells under lipopolysaccharide (LPS) stimulation.</p><p><b>METHODS</b>Ethyl acetate fractions were prepared from five different types of Jeju seaweeds, Dictyopteris divaricata (D. divaricata), Dictyopteris prolifera (D. prolifera), Prionitis cornea (P. cornea), Grateloupia lanceolata (G. lanceolata), and Grateloupia filicina (G. filicina). They were screened for inhibitory effects on proinflammatory mediators and cytokines such as nitric oxide (NO), prostaglandin E2, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6).</p><p><b>RESULTS</b>Our results revealed that D. divaricata, D. prolifera, P. cornea, G. lanceolata, and G. filicina potently inhibited LPS-stimulated NO production (IC50 values were 18.0, 38.36, 38.43, 32.81 and 37.14 µg/mL, respectively). Consistent with these findings, D. divaricata, D. prolifera, P. cornea, and G. filicina also reduced the LPS-induced and prostaglandin E2 production in a concentration-dependent manner. Expectedly, they suppressed the expression of inducible NO synthase and cyclooxygenase-2 at the protein level in a dose-dependent manner in the RAW 264.7 cells, as determined by western blotting. In addition, the levels of TNF-α and IL-6, released into the medium, were also reduced by D. divaricata, D. prolifera, P. cornea, G. lanceolata, and G. filicina in a dose-dependent manner (IC50 values for TNF-α were 16.11, 28.21, 84.27, 45.52 and 74.75 µg/mL, respectively; IC50 values for IL-6 were 37.35, 80.08, 103.28, 62.53 and 84.28 µg/mL, respectively). The total phlorotannin content was measured by the Folin-Ciocalteu method and expressed as phloroglucinol equivalents. The content was 92.0 µg/mg for D. divaricata, 151.8 µg/mg for D. prolifera, 57.2 µg/mg for P. cornea, 53.0 µg/mg for G. lanceolata, and 40.2 µg/mg for G. filicina.</p><p><b>CONCLUSIONS</b>Thus, these findings suggest that Jeju seaweed extracts have potential therapeutic applications for inflammatory responses.</p>

Jeju seaweeds suppress lipopolysaccharide-stimulated proinflammatory response in RAW 264.7 murine macrophages

Objective: To investigate the anti-inflammatory effects of Jeju seaweeds on macrophage RAW 264.7 cells under lipopolysaccharide (LPS) stimulation. Methods: Ethyl acetate fractions were prepared from five different types of Jeju seaweeds, Dictyopteris divaricata (D. divaricata), Dictyopteris prolifera (D. prolifera), Prionitis cornea (P. cornea), Grateloupia lanceolata (G. lanceolata), and Grateloupia filicina (G. filicina). They were screened for inhibitory effects on proinflammatory mediators and cytokines such as nitric oxide (NO), prostaglandin E

Inhibitory Effect of Ulva fasciata and Desmarestia viridis on the Production of Nitric Oxide, Prostaglandin E2, and Pro-inflammatory Cytokines in RAW 264.7 Cells.

Nitric oxide (NO) and prostaglandin (PG)E2, known inflammatory mediators, are critically involved in the pathogenesis of a large number of human inflammatory diseases. Therefore, a search of inducible nitric oxide synthases (iNOS) and cyclooxygenase 2 (COX-2) selective inhibitors is a useful strategy to find functional substances to alleviate inflammatory disease. In our search for anti-inflammatory ingredients, we found that extracts of Ulva fasciata (UFE) and Desmarestia viridis (DVE) inhibit the generation of NO and PGE2 in lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophage cells. U. fasciata and D. viridis were extracted with 80% ethanol and then partitioned successively with ethyl acetate. The ethyl acetate fractions are effective dose-dependent inhibitors of LPS-induced NO and PGE2 synthesis in RAW 264.7 cells. To test the inhibitory effects of UFE and DVE on pro-inflammatory cytokines, we performed ELISA assays for tumor necrosis factor (TNF)-α, IL (interleukin)-1β, and IL(interleukin)-6 in LPS-stimulated RAW 264.7 macrophage cells. In these assays, the UFE and DVE showed a dose-dependent decrease in the production of TNF-α, IL-1β, and IL-6. As a preliminary study of the anti-inflammatory mechanism, we determined, using the Western blot analysis, whether or not UFE and DVE inhibit the degradation of I-kappa-B-alpha (IκB-α). Our results indicate that UFE and DVE indeed prevent the degradation of IκB-α, in a dose-dependent manner. Based on these results, we suggest that extracts of U. fasciata and D. viridis be considered candidates for anti-inflammatory agents for human use.

Down-regulation of tyrosinase, TRP-1, TRP-2 and MITF expressions by citrus press-cakes in murine B16 F10 melanoma

Objective: To investigate the suitability of citrus-press cakes, by-products of the juice industry as a source for the whitening agents for cosmetic industry. Methods:Ethylacetate extracts of citrus-press cakes (CCE) were examined for their anti-melanogenic potentials in terms of the inhibition of melanin production and mechanisim of melanogenesis by using Western Blot analysis with tyrosinese, tyrosinase-related protein-1 (TRP-1), TRP2, and microphthalmia-associated transcription factor (MITF) proteins. To apply the topical agents, citrus-press cakes was investigated the safety in human skin cell line. Finally flavonoid analysis of CCE was also determined by HPLC analysis. Results: Results indicated that CCE were shown to down-regulate melanin content in a dose-dependent pattern. The CCE inhibited tyrosinase, TRP-2, and MITF expressions in a dose-dependent manner. To test the applicability of CCE to human skin, we used MTT assay to assess the cytotoxic effects of CCE on human keratinocyte HaCaT cells. The CCE exhibited low cytotoxicity at 50 μg/mL. Characterization of the citrus-press cakes for flavonoid contents using HPLC showed varied quantity of rutin, narirutin, and hesperidin. Conclusions:Considering the anti-melanogenic activity and human safety, CCE is considered as a potential anti-melanogenic agent and may be effective for topical application for treating hyperpigmentation disorders.

Clinical and Angiographic Outcomes of Wide-necked Aneurysms Treated with the Solitaire AB Stent

OBJECTIVE: This study investigated the clinical and angiographic outcomes of treatment with stent-assisted coil embolization using the Solitaire AB stents for wide-necked intracranial aneurysms. METHODS: From October 2010 to December 2011, 22 patients with aneurysms were treated with the Solitaire AB stent. One patient with a dissecting aneurysm was excluded, thus 21 patients with 21 wide-necked saccular aneurysms were included in this study. The technical success rate, procedure-related complications, initial and follow-up angiographic results, and clinical outcomes were retrospectively collected. RESULTS: The locations of aneurysms were as follows: paraclinoid in 14, distal internal carotid artery in 4, and vertebral artery in 3 patients. All aneurysms were unruptured and less than 10 mm-sized. The mean dome-to-neck ratio of the aneurysms was 1.00 (range: 0.45-1.81). The mean follow-up duration was 12.1 (7-15) months after the initial procedure. The technical success rate was 21 (95.5%) of 22 patients with aneurysms. Fortunately, there were no procedure-related complications. Follow-up angiography showed that the rate of complete occlusion was 57.1%, neck remnants 38.1%, and incomplete occlusion 4.8%. CONCLUSION: We suggest that using Solitaire AB stent is technically feasible and safe in the stent-assisted coil embolization for wide-necked saccular intracranial aneurysms. To evaluate the long-term effects of this stent, further follow-up angiography is needed.

Clinical and Angiographic Outcomes of Wide-necked Aneurysms Treated with the Solitaire AB Stent

OBJECTIVE: This study investigated the clinical and angiographic outcomes of treatment with stent-assisted coil embolization using the Solitaire AB stents for wide-necked intracranial aneurysms. METHODS: From October 2010 to December 2011, 22 patients with aneurysms were treated with the Solitaire AB stent. One patient with a dissecting aneurysm was excluded, thus 21 patients with 21 wide-necked saccular aneurysms were included in this study. The technical success rate, procedure-related complications, initial and follow-up angiographic results, and clinical outcomes were retrospectively collected. RESULTS: The locations of aneurysms were as follows: paraclinoid in 14, distal internal carotid artery in 4, and vertebral artery in 3 patients. All aneurysms were unruptured and less than 10 mm-sized. The mean dome-to-neck ratio of the aneurysms was 1.00 (range: 0.45-1.81). The mean follow-up duration was 12.1 (7-15) months after the initial procedure. The technical success rate was 21 (95.5%) of 22 patients with aneurysms. Fortunately, there were no procedure-related complications. Follow-up angiography showed that the rate of complete occlusion was 57.1%, neck remnants 38.1%, and incomplete occlusion 4.8%. CONCLUSION: We suggest that using Solitaire AB stent is technically feasible and safe in the stent-assisted coil embolization for wide-necked saccular intracranial aneurysms. To evaluate the long-term effects of this stent, further follow-up angiography is needed.

Coil Embolization of Ruptured Thrombosed Distal Superior Cerebellar Artery Aneurysm: A Case Report

Distal thrombosed aneurysm of the superior cerebellar artery (SCA) is extremely rare and is often associated with cerebellar infarction or subarachnoid hemorrhage. We report herein on a case involving a patient with a ruptured thrombosed distal SCA aneurysm which was treated successfully through the endovascular approach.

Efficacy of the Disappearance of Lateral Spread Response before and after Microvascular Decompression for Predicting the Long-Term Results of Hemifacial Spasm Over Two Years

OBJECTIVE: The purpose of this large prospective study is to assess the association between the disappearance of the lateral spread response (LSR) before and after microvascular decompression (MVD) and clinical long term results over two years following hemifacial spasm (HFS) treatment. METHODS: Continuous intra-operative monitoring during MVD was performed in 244 consecutive patients with HFS. Patients with persistent LSR after decompression (n=22, 9.0%), without LSR from the start of the surgery (n=4, 1.7%), and with re-operation (n=15, 6.1%) and follow-up loss (n=4, 1.7%) were excluded. For the statistical analysis, patients were categorized into two groups according to the disappearance of their LSR before or after MVD. RESULTS: Intra-operatively, the LSR was checked during facial electromyogram monitoring in 199 (81.5%) of the 244 patients. The mean follow-up duration was 40.9+/-6.9 months (range 25-51 months) in all the patients. Among them, the LSR disappeared after the decompression (Group A) in 128 (64.3%) patients; but in the remaining 71 (35.6%) patients, the LSR disappeared before the decompression (Group B). In the post-operative follow-up visits over more than one year, there were significant differences between the clinical outcomes of the two groups (p<0.05). CONCLUSION: It was observed that the long-term clinical outcomes of the intra-operative LSR disappearance before and after MVD were correlated. Thus, this factor may be considered a prognostic factor of HFS after MVD.

Predicting Factors Affecting Clinical Outcomes for Saccular Aneurysms of Posterior Inferior Cerebellar Artery with Subarachnoid Hemorrhage

OBJECTIVE: The aim of this study is to investigate the clinical outcomes of surgery and coiling and analyze the predicting factors affecting the clinical outcomes of ruptured posterior inferior cerebellar artery (PICA) aneurysms. METHODS: During the last 15 years, 20 consecutive patients with ruptured PICA aneurysms were treated and these patients were included in this study. The Fisher's exact test was used for the statistical significance of Glasgow Outcome Scale (GOS) according to initial Hunt-Hess (H-H) grade, treatment modalities, and the presence of acute hydrocephalus. RESULTS: Eleven (55%) and nine (45%) patients were treated with surgical clipping and endovascular treatment, respectively. Among 20 patients, thirteen (65.0%) patients had good outcomes (GOS 4 or 5). There was the statistical significance between initial poor H-H grade, the presence of acute hydrocephalus and poor GOS. CONCLUSION: In our study, we suggest that initial H-H grade and the presence of acute hydrocephalus may affect the clinical outcome rather than treatment modalities in the ruptured PICA aneurysms.

Pregnancy Related Venous Hemodynamic Changes in Lower Extremity: an Air-plethysmography Study / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to research the physiologic effects of pregnancy on lower extremity venous hemodynamics. METHODS: Forty-eight limbs of twenty four women in third trimester were studied with air plethysmography (APG) and duplex scan. The 48 limbs were divided into two groups three separate times using three sets of criteria, parity, weight gain and symptoms (leg swelling, varicose, telangiectasia). Each set of two groups was then compared by hemodynamic results (venous filling index (VFI), ejection fraction (EF), ambulatory venous pressure (AVP)) of APG. Nine of them had follow up test after delivery. RESULTS: None of twenty four women had thrombosis or reflux in duplex scan evaluation. Forty two limbs (87.5%) in VFI testing, thirty nine limbs (81.2%) in EF testing and forty one limbs (85.4%) in AVP testing showed normal value. There were no significant statistical differences in hemodynamic parameter between any of the two groups divided by parity or weight gain or symptoms. CONCLUSION: Although the belief that the mechanical effects of the gravid uterus plays important role in causing venous disease of pregnant women, over eighty percent of pregnant women showed normal results in lower extremity venous hemodynmics study with APG. According to this studies parity, weight gain, venous symptoms do not affect hemodynamic conditions. Hormonal or other systemic factors must play a significant role in the development of venous disease.

Molecular Biological and Pathological Aspects of Intercostal Muscles and Intervertebral Discs in Adolescent Idiopathic Scoliosis in Korea / 대한척추외과학회지

STUDY DESIGN: A molecular biological study of intercostal muscles and intervertebral disc cells of Korean scoliosis patients. OBJECTIVES: To study the pathological results of intercostal muscles and molecular biological activity of intervertebral disc cells of the scoliotic major curve in Korean patients. SUMMARY OF LITERATURE REVIEW : The cause of idiopathic scoliosis has been investigated in terms of many parameters. Although, molecular biological studies of intercostal muscles and intervertebral disc cells have been performed in foreign countries, few studies have been conducted in Korea. MATERIALS AND METHODS: Ten patients, one male and nine female, who underwent thoracoscopic surgery were reviewed. The age range was 13 to 23 years old. Intercostal muscles were taken from the portal site of the major curve (1x1 cm sized). Ten tissues were stained with H/E and ATPase immunohistochemical staining. An appropriate amount of intervertebral disc was taken from the major curve of three scoliotic patients and each concentration of collagen type I, II, GAG gene and proteoglycan synthesis activity was measured. The results were compared with those of grade 0 and grade II degenerative change on each MRI. RESULTS: The intercostal muscle of scoliotic patients showed 60.4+/-8.4% in type I muscle fiber and 39.6+/-8.8% in type II-A. These results were not different from those of previous studies. The size of muscle fiber was 48-65 microns, which was slightly smaller than the absolute value, but the difference was not statistically significant. The amount of produced proteoglycans was slightly higher in the intervertebral disc cells of scoliotic patients, the total amount of collagen was significantly lower and there was a difference in the production of type II collagen. CONCLUSIONS: The intercostal muscles were not affected by the muscle of scoliotic patients and there was no molecular biological significant difference between control and scoliotic patients. We can assume that scoliosis was not caused by problems of intervertebral disc or intercostal muscles.

Clinical Features and Surgical Results of ICA Bifurcation Aneurysms

OBJECTIVE: The aneurysms developed at internal carotid artery(ICA) bifurcation can be different from other aneurysms because there are many perforating arteries and the hemodynamic changes are characteristic. In this report, we present our cases of ICA bifurcation aneurysms and discuss the clinical features and surgical outcomes of these aneurysms. METHODS: From January 1989 to May 2001, total 808 patients(982 aneurysms) were operated for intracranial aneurysms at our hospital. Among them, twenty two patients(2.7%) had aneurysms at ICA bifurcation. We discussed clinical features according to mental status at admission, size, direction and multiplicity of aneurysms, presence of intracranial hemorrhage and rupture of ICA bifurcation aneurysms. And we also discussed the surgical results of operations depending on pre-operative Hunt-Hess grade and size of aneurysms. RESULTS: Mean age was 43.4 years old and 10 cases(45.5%) were below 40 years old. Six patients(27.2%) had large or giant aneurysms. Fifteen(68.2%) out of 22 patients had good results, 1 fair, 1 poor and 5 dead. CONCLUSION: In our ICA bifurcation aneurysm cases, we conclude that their onset is relative in younger age, and they has a higher incidence of multiple(34.6%) and larger aneurysm(27.2%) than other anterior circulatory aneurysm. And the surgical results of ICA bifurcation aneurysm are relatively poor.

A Case of Inflammatory Fibroid Polyp Presenting with Jejunal Bleeding / 대한소화기학회지

Inflammatory fibroid polyp occurs very rarely in the jejunum and gastrointestinal bleeding as an initial manifestation of inflammatory fibroid polyp has not been reported. We report a case of a jejunal inflammatory fibroid polyp presenting with melena for 10 days. Upper gastrointestinal endoscopic examination was negative for any active bleeding lesions and abdominal angiography failed to localize the bleeding site as well. In contrast, computed tomography of the abdomen demonstrated a segmental wall thickening of the jejunum with a tumor-like mass lesion associated with dense contrast enhancement. Consistent with this, technetium 99m red blood cells scintigraphy exhibited red cell pooling at the right upper quadrant. On exploratory laparotomy, there was an active bleeding from the site of the jejunal tumor and a segmental resection was performed. Histologically, the tumor lesion of the jejunum was consistent with inflammatory fibroid polyp. Thus, we conclude that the tumor lesion was a cause of the gastrointestinal bleeding.